Department of Infectious Diseases, Shunde Hospital of Southern Medical University, Foshan, China.
Department of Infectious Diseases, The First Hospital of Shanxi Medical University, Taiyuan, China.
Adv Clin Exp Med. 2022 Jul;31(7):731-738. doi: 10.17219/acem/146859.
Hepatitis B virus (HBV) infection is one of the most common infections, affecting 248 million people worldwide. Hepatitis B virus can progress to cirrhosis, liver failure and hepatocellular carcinoma (HCC).
To analyze the clinical characteristics and survival time of HCC occurrence in patients with HBV infection after virus turning negative.
The Kaplan-Meier and log rank survival analysis were performed to compare the overall survival (OS) of the patients with HCC in different groups.
The 1-, 3- and 5-year OS rates of the 104 investigated patients were 76.4%, 54.4% and 20.5%, respectively. The median survival time was 37 months. The median survival time of HBV-DNA-negative group was longer than that of the HBV-DNA-positive group (negative compared to positive: 42 compared to 36, p = 0.003). The 5-year OS rate of patients receiving antiviral therapy before HCC diagnosis in the HBV-DNA-negative group was higher than that in the HBV-DNA-positive group (negative compared to positive: 53.0% compared to 0%, p = 0.022). There was no significant difference in the 5-year OS rate in patients who did not receive antiviral therapy before HCC diagnosis between HBV-DNA-negative and HBV-DNA-positive groups (p = 0.195).
Among HBV-infected patients, a significant proportion of virus-negative patients develop liver cancer and require long-term continuous monitoring. A long-term effective antiviral therapy can improve the survival rate of patients with liver cancer. This study revealed important clinical characteristics of HCC patients and provided useful information for their clinical management and monitoring.
乙型肝炎病毒(HBV)感染是最常见的感染之一,影响全球 2.48 亿人。HBV 可进展为肝硬化、肝功能衰竭和肝细胞癌(HCC)。
分析 HBV 感染患者病毒转阴后 HCC 发生的临床特征和生存时间。
采用 Kaplan-Meier 和对数秩生存分析比较不同组 HCC 患者的总生存率(OS)。
104 例患者的 1、3 和 5 年 OS 率分别为 76.4%、54.4%和 20.5%。中位生存时间为 37 个月。HBV-DNA 阴性组的中位生存时间长于 HBV-DNA 阳性组(阴性组与阳性组比较:42 个月比 36 个月,p=0.003)。HBV-DNA 阴性组 HCC 诊断前接受抗病毒治疗的患者 5 年 OS 率高于 HBV-DNA 阳性组(阴性组与阳性组比较:53.0%比 0%,p=0.022)。HBV-DNA 阴性组 HCC 诊断前未接受抗病毒治疗的患者 5 年 OS 率在 HBV-DNA 阴性组和 HBV-DNA 阳性组之间无显著差异(p=0.195)。
在 HBV 感染患者中,相当一部分病毒阴性患者发生肝癌,需要长期持续监测。长期有效的抗病毒治疗可以提高肝癌患者的生存率。本研究揭示了 HCC 患者的重要临床特征,为其临床管理和监测提供了有用信息。